Custom Skull Implant Replacement

Q: Dr. Eppley, I am interested in a custom skull implant replacement. I am a patient of yours from 2014. You performed a successful skull implant surgery on me and I am extremely grateful. There certainly has been some improvement in my life – it usually takes a bit less time for me to get ready, etc. However, as I know that you offer 2 stages of the custom implant – one which entails using a spacer to enlarge the implant area, and I opted for the one-time only option, I was wondering if there is any ability to have a second surgery? I guess I am wondering if the first implant itself might have acted as a spacer of sorts, creating more room for a larger implant now? I truly don’t mean to sound vain or ungrateful, as the first implant surgery has absolutely helped! But I am still struggling more than I would like… I understand if this is not an option or simply a procedure you do not perform, but I thought it was worth asking before I gave up. I am not a body dysmorphic person or someone who will continue to seek the “next thing.” It’s really just that I am still relatively young, and with the efforts I am still having to make with my hair, to get ready, go swimming, etc, it makes me sad to think of spending the rest of my life this way. I was hoping to achieve (if possible) another few mm at the top and upper sides of my head. Thank you for your time, Dr. Eppley. I know you are very busy and I hope this email doesn’t find you rolling your eyes at someone who is ungrateful. Please know that is not the case.

A: Good to hear from you again. Your supposition that an indwelling scalp implant can act as a spacer or tissue expander is completely correct. A second skull implant (custom skull implant replacement) can be placed that is usually double the thickness of the first one (9 to 18mms in your case) as the scalp has had time to stretch and relax to accommodate its volume. Placing the second jmplant is usually a bit easier on the patient since much of the pocket (separating the scalp from the bone) has been done from the first surgery. As you may guessed, this is not the first time I have had this request so there is no eye rolling occurring. In reality this is just a different form of a two-stage skull augmentation approach…it just occurs over a longer period of time. And the good news is that I have not yet had anyone want to go on to a third skull implant.

Dr. Barry Eppley
Indianapolis, Indiana